
Beyaz
Beyaz is a combination birth control pill that contains 2 hormones — drospirenone (a progestin) and ethinyl estradiol (an estrogen) — along with levomefolate (a folic acid supplement). In addition to preventing pregnancy, Beyaz is FDA approved to treat premenstrual dysphoric disorder (PMDD), acne in those who have started their periods, and to help raise folate levels. The pill is taken by mouth once daily. Each 28-day pack contains 24 active hormone tablets and 4 placebo tablets. Common side effects include headache, abnormal bleeding, and breast tenderness.
What is Beyaz?
What is Beyaz used for?
- To prevent pregnancy
- Premenstrual dysphoric disorder (PMDD)
- Acne (in people 14 years and older who've started their periods)
- Supplement folic acid
How Beyaz works
Beyaz is a combination of two hormones, drospirenone (a progestin) and ethinyl estradiol (an estrogen). These two hormones work together to prevent pregnancy by:
- Stopping ovulation (preventing the release of an egg) and reducing hormone changes linked to ovulation
- Thickening cervical mucus to make it harder for sperm to reach an egg
- Thinning the uterine lining, making it less likely for a fertilized egg to implant
Beyaz works to treat PMDD by balancing hormone levels to reduce symptoms like mood swings, irritability, and bloating.
Beyaz also treats acne by lowering testosterone levels. This leads to less oil production and clogged pores.
Additionally, Beyaz also contains levomefolate, a folic acid supplement that can help lower the risk of birth defects.
Drug facts
| Common Brands | Beyaz |
|---|---|
| Drug Class | Estrogen / Progestin / Folate combined contraceptive |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Beyaz essentials
Side effects of Beyaz
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Pregnancy prevention, acne, folate supplementation:
- Headache or migraine (6%)
- Irregular menstrual bleeding (4%)
- Nausea or vomiting (4%)
- Breast pain or tenderness (3%)
PMDD:
- Irregular menstrual bleeding (25%)
- Nausea (16%)
- Headache (13%)
- Breast tenderness (11%)
Less Common Side Effects
- Feeling tired
- Feeling irritable
- Lower sex drive
- Weight gain
- Mood swings
Beyaz serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: chest pain, belly discomfort, sweating, nausea, dizziness
- Stroke: sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headache, difficulty walking
- Deep vein thrombosis (blood clot in the leg): leg cramp, swelling, pain, muscle tightness
- Pulmonary embolism (blood clot in the lung): cough, chest pain, trouble breathing, racing heart
- Liver or gallbladder problems: yellowing of the skin or the whites of the eyes, tiredness, pain in the right upper stomach, dark urine
- High potassium levels: muscle weakness, nausea, irregular heart beat
The following Beyaz side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Breast tissue changes, new lumps, redness, pain, or discharge from the nipple
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- High potassium level—muscle weakness, fast or irregular heartbeat
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- New or worsening migraines or headaches
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Worsening mood, feelings of depression
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Breast pain or tenderness
- Dark patches of skin on the face or other sun-exposed areas
- Irregular menstrual cycles or spotting
- Nausea
- Vomiting
- Weight gain
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Pros and cons of Beyaz
Pros
- Tablet taken by mouth once daily
- Placebo (hormone-free) pills contain a folic acid supplement
- Can prevent pregnancy, as well as treat acne and PMDD
Cons
- Raises the risk of serious blood clots
- Can cause unpleasant side effects, like headache, nausea, and vomiting
- Doesn't protect against sexually transmitted infections (STIs)
Pharmacist tips for Beyaz
- Beyaz helps prevent pregnancy, but it doesn't protect you against human immunodeficiency virus (HIV), hepatitis, or other sexually transmitted diseases (STIs). Using a condom along with Beyaz can help lower your risk of an STI.
- Beyaz isn't an emergency contraception (morning-after pill) and shouldn't be used after unprotected sex to prevent pregnancy. Talk to your gynecologist or pharmacist if you need emergency contraception, such as levonorgestrel (Plan B One-Step) or Ella (ulipristal).
- Try to take Beyaz around the same time every day. Setting a reminder or alarm can help you stay on schedule.
- You can start Beyaz in different ways. Take your first pill either on the first day of your period or on the first Sunday after your period begins. If you choose the Sunday start, use non-hormonal back-up birth control (like condoms) for the first week, unless your period started on that Sunday.
- If you missed one active Beyaz tablet, take it as soon as possible, then take your next pill at the usual time. This might mean taking two pills in one day. If you miss more than one pill, check the instructions on your pack or call your gynecologist for guidance. You might also need to use a back-up birth control for a week.
- You might experience irregular bleeding while taking Beyaz. Some people have heavier periods, while others might miss periods or have breakthrough bleeding. Keep taking Beyaz every day as directed by your gynecologist. Speak with them if you're concerned about changes in your period.
- Tell your gynecologist if you notice symptoms of depression or mood changes while taking Beyaz. If your depression becomes severe, they might recommend stopping the medication.
- Beyaz can interact with many medications. Tell your healthcare team about all prescription, over-the-counter, and supplement products you take before starting this medication.
- Let your healthcare team know if you're scheduled for surgery while taking Beyaz. This medication can raise your risk of blood clots after surgery, so your healthcare team will likely ask you to stop taking it at least a month before surgery and wait at least 2 weeks after surgery before restarting.
- Get medical help right away if you notice signs of a blood clot, including trouble breathing, leg pain that won't go away, or sudden, severe headache. Though rare, taking combined birth control pills, including Beyaz, can raise the risk of blood clots.
- Call 911 if you have sudden swelling around the face, lips, or throat that makes it hard to breathe. Though rare, Beyaz can trigger angioedema, especially in people who've had similar reactions before.
Risks and warnings for Beyaz
Beyaz can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Cigarette smoking and serious heart problems
- Risk factors: Over 35 years old who smoke cigarettes
Smoking cigarettes while using Beyaz can significantly raise your risk for blood clots. These blood clots can lead to more serious problems, such as heart attack and stroke. The risk is greater if you're over 35 years old and have a history of smoking cigarettes. If you smoke, talk with your gynecologist about safer birth control alternatives.
Risk of blood clot
- Risk factors: Age 35 or older and smoke | Recent surgery with a long period of bed rest | Starting Beyaz less than a month after childbirth | High blood pressure | | High cholesterol | People identified as obese | Diabetes | Higher dose of estrogen
Beyaz can raise the risk of serious blood clots because it contains ethinyl estradiol (an estrogen). Higher estrogen levels can lead to more blood proteins that stimulate clot formation. Some studies also suggest that birth control pills with drospirenone, like Beyaz, might have a higher risk of blood clots compared to pills with levonorgestrel or other progestins. These clots can be life-threatening and can form anywhere in your body. Get medical attention right away if you have any signs or symptoms of a blood clot:
- Brain (e.g., stroke): weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurry vision, dizziness, loss of balance, trouble walking, or confusion
- Eyes (e.g., retinal thrombosis): trouble seeing, bulging eye, or double vision
- Heart (e.g., heart attack): chest pain, sweating, nausea, or dizziness
- Lungs (e.g., pulmonary embolism or PE): trouble breathing, chest pain, or cough
- Legs (e.g., deep vein thrombosis or DVT): cramps, swelling, pain, or muscle tightness
Your risk of blood clots is higher if you're older, smoke cigarettes, or have certain medical conditions. It also increases if you're on bedrest after surgery or have just given birth. Your gynecologist will usually stop Beyaz 3 to 4 weeks before surgery and restart it 2 weeks after to lower your risk. If you recently delivered a baby, you should wait at least 4 weeks after delivery to start this medication, and only if you aren't breastfeeding. Talk with your gynecologist if you have any questions regarding your risk of blood clots.
High potassium
- Risk factors: Kidney, liver, or adrenal gland problems | Taking medications that raise potassium levels | Taking medications that raise Beyaz levels
Beyaz contains drospirenone, which can cause high levels of potassium in some people. Taking Beyaz with medications that raise potassium levels like ACE inhibitors, potassium-sparing diuretics, or potassium supplements can put you more at risk. Your gynecologist might monitor your potassium levels during your first cycle of Beyaz and periodically while you're taking it. Contact your health care team if you experience signs of high potassium like nausea, irregular heartbeat, or muscle weakness.
Breast and cervical cancer
- Risk factors: History of breast or cervical cancer | Taking Beyaz for a long time
Study results are mixed, but Beyaz and other combined hormonal birth control pills might raise your risk for breast and cervical cancer.
Don't take Beyaz if you currently have or have had breast cancer because some types of breast cancer grow faster in the presence of estrogen, which is in this medication. Perform breast self-checks regularly at home and get yearly breast exams with your gynecologist to help with early detection. Let them know if you notice any new or abnormal lumps, pain, or swelling in your breasts.
Make sure you follow up with your gynecologist to get proper screenings for cervical cancer. Report any signs of vaginal bleeding or discharge that's not normal.
Liver problems
- Risk factors: Taking Beyaz for more than 8 years | Certain hepatitis C medications
Don't use Beyaz if you have liver problems, such as hepatitis, severe cirrhosis, or liver tumors. Although rare, this medication can raise your risk of benign liver tumors. If you notice signs of liver problems, stop using Beyaz and talk to your gynecologist about other birth control options. Signs of liver problems include jaundice (yellowing of the skin or whites of the eyes), fever, tiredness, loss of appetite, or dark urine..
Gallbladder problems
Some studies suggest that Beyaz can raise the risk of gallbladder disease since more progestin and estrogen can lead to higher chance of gallstones. Although the risk is low, talk to your gynecologist if you have a history of gallbladder disease before starting this medication.
High blood pressure
- Risk factors: Older age | Using hormonal contraceptives for a long time | History of high blood pressure
Beyaz can raise your blood pressure. The risk is higher if you're older and have been using birth control for a long time. If you have a history of high blood pressure that's well-controlled, your prescriber might monitor you while you use Beyaz. If you have concerns, talk with them about the risks and benefits of using this medication.
High blood sugar and triglycerides
- Risk factors: Prediabetes or diabetes | High triglycerides
Beyaz can raise your blood sugar and triglycerides levels. If you have prediabetes or diabetes, your prescriber will likely monitor your blood sugar while you take this medication. High triglycerides can lead to a higher risk of pancreatitis (inflammation of the pancreas). Speak with your gynecologist before starting Beyaz if you have a history of high blood sugar or triglycerides. They might suggest a different birth control option or monitor your lab work more closely while you're using this medication.
Headache
Let your gynecologist know if you experience new or worsening migraines or headaches while using Beyaz. If you develop frequent, severe, or new headaches, you might need to stop the medication.
Irregular bleeding
- Risk factors: First 3 months of COCs
People who take Beyaz can sometimes experience irregular bleeding and spotting, especially during the first 3 months of taking this medication. Irregular bleeding can vary from slight staining to bleeding similar to a regular period. This problem is often temporary, so continue taking your medication as directed. If your bleeding doesn't stop, becomes heavier, or you miss a period after the initial bleeding, let your gynecologist know. Your gynecologist can perform blood tests to rule out pregnancy or other potential causes for bleeding.
Depression
- Risk factors: History of depression
If you have a history of depression, your prescriber will monitor you while using Beyaz. If your depression gets worse or becomes serious, they might stop the medication. Let your prescriber know if you experience mood changes, sadness, or loss of interest in activities while taking this medication.
Worsening of other health conditions
- Risk factors: History of hereditary angioedema | History of chloasma gravidarum
If you have certain conditions, such as hereditary angioedema or chloasma (a skin condition that causes dark patches on the face), talk to your prescriber before taking Beyaz because it might worsen your symptoms. If you have a history of chloasma, limit exposure to the sun or UV light while taking Beyaz.
Beyaz dosage
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets | 3 packages | $125.45 | $41.82 |
Typical dosage for Beyaz
Beyaz comes in a 28-day pack, which contains 24 active hormone tablets and 4 placebo tablets. Each active tablet contains 3 mg drospirenone and 20 mcg ethinyl estradiol. Each placebo tablet contains 0.451 mg levomefolate calcium.
Follow your prescriber's instructions on how to take this medication. The tablets must be taken in order as shown on the packaging.
The typical dose is 1 active tablet by mouth daily for 24 days, followed by 1 placebo tablet daily for the remaining 4 days.
How much does Beyaz cost?
Beyaz contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Beyaz will not be safe for you to take.
- Kidney or adrenal gland problems
- High risk for developing a blood clot
- History of blood clots, stroke, or heart attack
- Over 35 years old who smoke
- Currently have or have had a blood clot
- Blood clotting condition
- Stroke
- Coronary artery disease (CAD)
- Certain heart rhythm problems, like atrial fibrillation (AFib)
- High blood pressure that's not under control
- Diabetes with high blood pressure or organ damage
- Migraine headaches with aura
- Any migraine headaches for those over 35 years old
- Have a body mass index (BMI) at or greater than 30 kg/m²
- Liver problems or liver disease
- Unexplained vaginal bleeding that hasn't been diagnosed
- Currently have or have had breast cancer
- Take hepatitis C combination medications containing ombitasvir/paritaprevir/ritonavir
What are alternatives to Beyaz?
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